Santa Cruz Bible Church

VBC 2008 Registration Form

Sign My Child Up! I would like my child to ATTEND VBC 2008.

Form - powered by Form1 from www.softswot.com

Parent's first and last name

Camper's first name

Camper's last anme

Address 1

Address 2

City

State

Phone

Email address

T-shirt size

Attends church?

If yes, What Church?

Grade Entering

Age

Birthday

Gender

My child would like to sit with (enter only one)

To the best of my knowledge, my child is healthy and fit for camp

If no, please explain

Immunizations, are they current?

Date of last Tetanus shot

Regular medications?

Activity Restrictions

My child is currently experiencing or has recently had a problem with...

Other Medical Information we should know about?